title: Mucositis prevention by selective elimination of oral flora in irradiated head and neck cancer patients.
abstract: Mucositis induced by irradiation is the reactive inflammatory-like process of the oropharyngeal mucous membranes following irradiation. Bacteria colonizing the oral tissues are thought to contribute to this inflammatory process. The eradication of Gram-negative bacilli (selective elimination of oral flora) in fifteen comparably irradiated head and neck cancer patients was found to be associated with a significant reduction in mucositis compared with two groups of 15 patients receiving either placebo or chlorhexidine rinsing. Criteria used were the extent of local mucositis signs (mucositis score), as well as generalized side-effects such as the need of nasogastric tube feedings following severe feeding problems. Mucositis signs were confined to erythema only in all selectively decontaminated patients. No pseudomembranes were observed and artificial feeding was completely prevented. These promising results need further confirmation in larger (multicenter) studies.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital, Groningen, The Netherlands.
authors.forename: F K
authors.initials: FK
authors.lastname: Spijkervet
authors.forename: H K
authors.initials: HK
authors.lastname: van Saene
authors.forename: J J
authors.initials: JJ
authors.lastname: van Saene
authors.forename: A K
authors.initials: AK
authors.lastname: Panders
authors.forename: A
authors.initials: A
authors.lastname: Vermey
authors.forename: D M
authors.initials: DM
authors.lastname: Mehta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000666:Amphotericin B / Q000008:administration & dosage / Q000627:therapeutic use; D002180:Candidiasis, Oral / Q000209:etiology / Q000517:prevention & control; D003091:Colistin / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D005260:Female; D006090:Gram-Negative Bacteria / Q000187:drug effects*; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology*; D011446:Prospective Studies; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D013280:Stomatitis / Q000209:etiology / Q000517:prevention & control*; D014031:Tobramycin / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000666:Amphotericin B; D014031:Tobramycin; D003091:Colistin